Kiteboarding Head Injury

[ricki]

Someone is lofted or dragged to impact, often enough they may try to convince you and themselves that they are OK. This from personal experience and other stories I have heard about. The simply solution is to call for medical attention and have them evaluate the guy properly. This approach isn't used all the time, victims sometimes just want to walk it off (concussion and perhaps brain hemorrhage?!). Yes, that is what the walking is intended to address by some of the victims. There was at least one lofting victim who may well have suffered paralysis from this course of action.

So what to do? Call the EMTs, even if it means overruling the victim in what may be a serious case. If that isn't going to happen for whatever reason, good one or not, carefully consider the following from the CDC:

"One method to categorize victims of head injury is to consider them to be divided into two groups, according to whether or not they have lost consciousness. If a victim has not lost consciousness, this implies a lesser injury, but like everything in medicine, is not infallible. If someone has lost consciousness, even for a few seconds, the red flag is up for a potentially serious injury. Always be aware that the dazed or unconscious victim cannot protect his airway; you must be vigilant in your observation. The most common dangerous complication of head injury is obstruction of the airway with the tongue, blood, or vomitus. The most common associated serious injury is a broken neck.

Loss of Consciousness

If a person struck in the head has lost consciousness, he has suffered at least a concussion. The following signs and symptoms are commonly associated with a concussion: unaware of what happened; confusion; loss of memory; loss of consciousness; headache or sensation of pressure in the head; dizziness; balance problems; nausea; vomiting; feeling “foggy,” “dazed,” or “stunned;” visual problems (e.g., seeing stars or flashing lights, or seeing double); hearing problems (e.g., ringing in the ears); irritability or emotional changes; slowness or fatigue; inability to follow directions or slow to answer questions; easily distracted or poor concentration; inappropriate emotioinal behavior; glassy-eyed or vacant starting; slurred speech; seizure.

1. Protect the airway and cervical spine.

2. If the victim wakes up after no more than a minute or two and quickly regains his normal mental status and physical abilities, he has probably suffered a minor injury—so long as there is no relapse into unconsciousness or persistent lethargy, nausea or vomiting, or severe headache. If the victim is far from help, he should undertake no vigorous activity and be kept under close observation for at least 24 hours. Normal sleep should be interrupted every 2 to 3 hours to briefly ensure that his condition has not deteriorated. Confusion or amnesia for the event that caused the blackout is not uncommon and not necessarily serious, so long as the confusion does not persist for more than 30 minutes. Because a serious brain injury may not become apparent for hours, the wilderness traveler who has been "knocked out" should not venture farther from civilization for 24 hours. If headache and/or nausea persist beyond 2 to 3 hours, or if the victim seems in any way altered with respect to mental status, the victim should begin to make his way (assisted by rescuers) to medical care.

If the injury is minor and evacuation is not undertaken, advance the victim’s activity as follows: no activity and complete rest until without symptoms; next, light walking without any heavy lifting or resistance activity; next, mild exercise with slight resistance; finally, full activity. Do not progress beyond one “level” each 24 hour period.

3. If the victim wakes up and is at first completely normal, only to become drowsy or disoriented, or lapses back into unconsciousness (typically, after 30 to 60 minutes of normal behavior), he should be evacuated and rushed to a hospital. This may indicate bleeding from an artery inside the skull, causing an expanding blood clot (epidural hematoma) that compresses the brain. Frequently, the unconscious victim with an epidural hematoma will be noted to have one pupil significantly larger than the other.

4. If the victim awakens but has a severe headache, bleeding from the ears or nose with no obvious external injury to those organs, clear fluid draining from the ear or nose, unequal-sized or poorly reactive (do not constrict promptly upon exposure to bright light) pupils, weakness, bruising behind the ears or under the eyes, vomiting, or persistent drowsiness, he might have a skull fracture. Such signs mandate immediate evacuation to a medical facility.

5. If the victim suffers a seizure after a head injury, no matter how brief, he should be transported to a medical facility.

6. If the victim does not wake up promptly after a head injury (unconscious for more than 10 minutes), has bleeding from an ear, has unequal or nonreactive (do not constrict to bright light) pupils, has clear fluid from the nose, has a profound headache, is weak in an arm or leg, is disoriented, or has a fluctuating level of consciousness (normal one minute, drowsy the next), he may have suffered a significant brain injury and should be immediately rushed to a medical facility. Because there is a high incidence of associated neck injuries, any person with a serious head injury should have his cervical spine immobilized. Head injuries often cause vomiting. Therefore, be prepared to turn the victim on his side so that he doesn’t choke.


Tags: concussion, CDC, health, wilderness medicine, outdoor medicine, healthline
From: http://tinyurl.com/5kvvrk

[conchxpress]

Good post Rick. All the more reason why the efforts should continue to get the posts removed from Smathers beach. The area where they are located is not a prominent swimming area, and it's so shallow that boats don't ever encroach upon the area in question. I was told that there were inroads to this problem. Have you heard any news? Maybe Paul or Greg can enlighten us. I'm not aware of any significant injuries, but they have eaten a kite or two. In addition, they seem to be located in prime landing areas.

Frank

[ricki]

I started looking for a general reference like this dealing the head injuries after a tragic accident in Mauritius several years ago. The vacationing Russian kiter suffered a board impact in squally weather due to the use of a board leash. He had a brain hemorrhage but didn't realize it as his life bled out. I really didn't find a good, concise reference from an authoritative source at the time. Nor did I realize the import of my head injury as I stomped around for hours for that matter however things turned out to be more benign in my case. The victim often is the last to know after all much less react responsibly. This post is more for bystanders of such accidents to serve as a guide. We really should think about this stuff as you never know when you might be on the scene of a head/cervical injury and in a position to help.

Greg had spoken about approaching the City regarding kiteboarding at east Smathers and some reforms some time back. I am not sure where those discussions are at this point. If the City supports kiteboarding as a concept and public pursuit, great. If not, such requests could bring undesirable attention. At the time I suggested some private discussions with authorities to evaluate likely responses prior to approaching City officials publically. A couple of the maker posts may go in time in this area. This will no doubt spare some kites and maybe even some acutely incautious kiters. This will still leave the rock groin and the sand beach. Most cases these sorts of injury among kiters involve impacts on land. The beach and jetty will remain dictating that afirmative moves will have to come from the kiters in the form of responsible, informed riding practices. Nothing new there.